The invention generally relates to oral airways and, in particular to oral airways that facilitate fiber-optic intubation of the trachea.
Oral airways are well known. Generally, an oral airway is a device used in anesthesia to maintain patency of the path from the mouth of a patient to the pharynx of the patient. Oral airways are commonly utilized in mask ventilation for CPR or induction of anesthesia.
One use of oral airways is to facilitate fiber-optic intubation of the trachea with an endotracheal tube. The oral airway splints open the teeth providing a conduit through which a thin filamentous fiber-optic bronchoscope may be passed from the mouth through the vocal cords so that, in turn, an endotracheal tube may be passed over the fiber-optic scope through the oral airway to the proper position through the vocal cords. Such technique is sometimes known as the “Seldinger” technique.
The basic design of conventional oral airways in use today is that of a hollow plastic tube which, when placed between the teeth as a bite block, follows a natural curve to the posterior pharynx to pull the tongue forward to facilitate passage of a fiber-optic tube bronchoscope to the larynx and through the vocal cords.
Each of the following U.S. patent references discloses conventional oral airways: Ovassapian U.S. Pat. No. 5,024,218; Williams U.S. Pat. No. 4,338,930; Berman U.S. Pat. Nos. 4,067,331, 4,054,135, and 3,930,507; Northway-Meyer U.S. Pat. No. 4,848,331; and Alfery U.S. Patent Application Publication No. 2003/0000534. Each of these U.S. patent references is hereby incorporated herein by reference.
Currently available commercial products that are believed to be based on the Ovassapian, Berman, and Williams patented oral airways discussed above are illustrated in FIGS. 1-4.
FIGS. 1 and 2 are a top and side perspective view, respectively, of a commercially available oral airway 10 believed to represent the Ovassapian oral airway. As shown therein, the airway 10 includes a wide, flat lingual surface 12 that allows for stability of the oral airway and forward depression of the tongue, both of which increase the ease of positioning the fiber-optic scope. The construction of this oral airway 10 is perhaps best illustrated in the incorporated reference U.S. Pat. No. 5,024,218. Unfortunately, the oral airway 10 has been found to tend to direct the fiber-optic scope and endotracheal tube posteriorly toward the esophagus rather than anteriorly toward the trachea. The oral airway 10 also has been found to be very difficult to remove without disrupting placement of an endotracheal tube after the endotracheal tube has been properly positioned with respect to the trachea.
With reference to FIG. 3, a commercially available oral airway 20 believed to represent the Williams oral airway is shown and includes a posterior pharyngeal curve 22 that tends to direct a fiber-optic scope and endotracheal tube anteriorly toward the trachea. The construction of this oral airway 10 is perhaps best illustrated in the incorporated reference U.S. Pat. No. 4,338,930. Unfortunately, the oral airway 20 has been found to be very narrow and to wobble in a patient's mouth, thereby making the fiber-optic scoping process difficult. The oral airway 20 also has been found to be cumbersome to remove without disrupting placement of an endotracheal tube after the endotracheal tube has been properly positioned with respect to the trachea.
Finally, with reference to FIG. 4, a commercially available oral airway 30 believed to represent the Berman oral airway is shown and includes, on one side, a sidewall having a first opening or cutaway section (not shown) that extends the entire length of the oral airway 30 and, on the other side as shown, a sidewall having a second opening or cutaway section 32 that generally extends along the midsection of the oral airway 30, with the sidewall further including hinging sections 35 disposed there along. The hinging sections 35 permit the opening of the oral airway, i.e., expansion of the first opening or cutaway extending the entire length of the oral airway 30, for easy removal of a fiber-optic scope or endotracheal tube. While permitting hinging movement, the hinging sections 35 nevertheless continuously join the oral airway 30 such that the oral airway 30 is considered to be a single integral unit. The construction of this oral airway 30 is perhaps best illustrated in the incorporated reference U.S. Pat. No. 4,054,135. Unfortunately, the oral airway 30 has been found to be very narrow and unstable and to include a posterior curve that tends to direct a fiber-optic scope and endotracheal tube posteriorly toward the esophagus instead of anteriorly toward the trachea.
Even in view of the conventional oral airways, it is believed that a need exists for still yet further improvement in oral airways used to facilitate fiber-optic intubation of the trachea.